North Network: The Nursing Role

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North Network The Nursing Role

• Rachael Buttrum, Aimee Campbell, Anne Courtice,
  Shannon Nichols, Kristin Maydell-Scanlan

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What is the North Network?

• NORTH Network is a program of Sunnybrook Health
  Sciences Centre (SHSC) dedicated to improving
  access to health care across Ontario through
  telemedicine.
• NORTH Network partners with public and private
  organizations to pursue clinical and educational
  initiatives that benefit the citizens of Ontario
  and their public sector health organizations.

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What is the North Network?

• The opportunity to see, hear and talk to a health
  care specialist via two-way television.
• Like a regular check-up, only on the specialist
  you will be seeing and speaking with is on a
  television screen.
• The specialist already has information about the
  patient.
• May need to change into a gown depending on the
  type of assessment.
• Consent form must be signed before the
  appointment begins.
• Pt is put in an examination room.
• Private and confidential

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Why is the North Network Needed?

• Rural northern communities have access to
  specialists who are located in urban centres.
• Improve access to health care
• Provide advanced health care

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Benefits of North Network

• Cuts travel costs (patient transfer) and travel
  related risks
• More efficient and convenient.
• Brings health care to any patient anywhere,
  anytime
• Enhances opportunity for educational advancement
  for learners in communities in northern Ontario.

• Ability to hold important conferences which can
  be broadcasted anywhere which can incorporate a
  larger and more wide variety of individuals.
• It makes use current technology that is
  available to improve the health and access to
  health care in rural areas on Ontario.

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Where is the North Network Used?
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How Does the North Network Work?

• A connection is established via IP (internet
  protocol)
• On the television screen the patient can then see
  the other health care professional
• The health care professional assesses the patient
  through the use of interactive tools.

• Tools
• VCR
• Doc camera
• Patient exam camera
• ENT scope
• Electronic stethoscope

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North Network Equipment
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Who is Involved with the North Network?

• TelehealthCoordinator (THC)
• Often a nurse or regulated health care
  professional
• Sometimes the role is shared between a nurse and
  an administrative person
• Medical Director
• There is a Medical Director in every hospital
  that is a member of NORTH.
• Medical Directors are physicians who serve as
  leaders in their community and who receive an
  honorarium from NORTH Network to work with their
  local healthcare professionals and administrators
  in the successful promotion and management of
  telemedicine services.

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Who is involved with the North Network?

• Regional Telehealth Coordinator (RTHC)
• RTHCs are located in major referral centres to
  promote the use of the technology within the
  larger community/region and liaise with
  colleagues in both rural and urban centres.
• RTHC facilitates communication between referring
  and specialist sites to achieve seamless
  integration of clinical services and education
  using videoconferencing into everyday healthcare
  delivery.
• Regional Medical Directors (RMD)
• RMDs are physicians located at the referral
  centres in each of the major regions
• that manage regional clinical activities and act
  as a resource for Medical Directors
• Promoting the use of telemedicine in the region,
  managing regional communication strategies and
  managing regional stakeholder relationships.

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Case Study

• John Smith is a 70 year old male patient from
  Moose Factory.
• He has presented to the small 10 bed hospital, ER
  with
• Confusion
• Blurred vision
• Altered speech
• L sided weakness
• Sudden severe headache

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Case Study

• Physician
• Called CritiCall, a provincial emergency referral
  program to access the on-call neurologist.
• The neurologist then views the patients CT image
  from computer workstations in their offices or
  home
• After discussing and reviewing the case, the
  neurologist then initiates a live North Network
  teleconference to conduct a neurological
  assessment.
• John, and his wife Jane, as well as the ER
  physician and the primary RN were able to
  interact during the conference with the
  neurologist.

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Nursing Roles

• Prepare the teleconferencing equipment
• Prepare the patient for the conference
• Informed consent
• Explain procedure
• Physical preparation
• Conduct physical assessments for the other health
  care professional
• Take vitals
• Follow directives in performing assessments

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Nursing Roles

• Maintain patient confidentiality
• Act as a patient advocate
• Questions
• Provide teaching re patient questions about the
  procedure.
• Clarification
• Clean up teleconferencing equipment.

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Discussion Questions

• Can you think of any situations where the North
  Network would be more beneficial to use?
• Has anyone had an experience with the North
  Network?
• Are there are drawbacks to the North Network?